Background

Inflammatory bowel diseases (IBD), mainly Crohn's disease (CD) and ulcerative colitis (UC), may affect young female patients, including their childbearing years. Managing patients with IBD during pregnancy can be challenging. An objective biomarker for disease activity could serve as an important decision making tool, and may render unnecessary invasive diagnostic procedures. Fecal calprotectin level is being used as a non-invasive bio-marker in IBD patients. However, its use in pregnant IBD patients, is not well validated. We aimed to evaluate the use of fecal calprotectin levels as a biomarker for disease activity in pregnant IBD patients.

Methods

A prospective study was conducted among pregnant women in our IBD MOM clinic. All clinical data including Partial Mayo score and Harvey Bradshaw index were calculated as well as fecal calprotectin, ESR, CRP and albumin values. Statistical analysis was done to assess the correlation between the fecal calprotectin levels, clinical scores and laboratories indexes.

Results

Study population included 33 pregnant women with IBD, twenty patients with CD and 13 with UC. Mean age was 29 ± 5 years. Mean calprotectin in UC and CD were 376 ± 218 and 241 ± 860 mg/ kg, respectively. No differences were noted in calprotectin levels during the pregnant trimesters. Interestingly, no correlation was noted between calprotectin and clinical scores, albumin levels, ESR or CRP (p=0.285, p=0.986, p=0.327 and p=0.491, respectively).

Conclusion

This prospective study in pregnant IBD patients, demonstrated the limitations of using fecal calprotectin as a non-invasive biomarker for disease activity during pregnancy. Clinicians should be aware of this limitation, and further studies to validate such markers should be considered.